Ms.
Macpherson, Director of Administrative Services, distributed a draft of the
proposed budget to the members of the Board. She explained that this budget is
mostly complete; however there are some details that still need to be
finalized. These changes including any made tonight from the Board will all
need to be completed by next Thursday, as the budget numbers have to be entered
into the County’s budget system by Friday, August 28th.

As a
result of the county’s resource allocation for 2010, the Department will
receive approximately $77,000 less in tax dollars than in 2009. She discussed
the overall impact of the budget on reserves in 2009, which will be slightly
higher than originally anticipated. But she pointed out that the Department
added $300,000 to the fund balance at the close of 2008, which will help cover
the anticipated budget constraints in 2009 and into 2010. She explained some anticipated
expense savings and increased revenues, including delayed implementation of the
on-call compensa­tion plan (not implemented in 2009 but re-budgeted in 2010),
leaving positions or parts of positions vacant, taking on some new grants
without expanding staffing, and getting new grants that help support the
Department with indirect costs. She also explained the recent grant award of
approximately $110,000 for H1N1 pandemic response planning, with more funds to
follow. The Department most likely will be hiring temp staff and increasing
hours worked for some existing staff for the mass immunization effort. Ms.
Macpherson explained to the BOH members of the intent to use these grant monies
to cover H1N1 expenses before needing to use County resources..

Ms.
Macpherson discussed the use of reserves in the revised 2009 and the 2010
budgets. Even with a projected use of over $391,000 of fund balance in 2010,
the Department will still have enough reserves to stay comfortably within the
10% of total expense budget fund balance guidelines. She stressed that this
year and next are not years in which it would be wise to reduce the
Department’s workforce because of the need to have public health workers
available to respond to the emerging pandemic. However, should this rate of fund
balance use continue into 2011, the Department would need to plan for changes
to reduce the reliance on reserves.

She
indicated that the Department has always been conservative with revenue
estimates and has always worked to have expense savings. Most years when a
fund balance use is projected, a much smaller amount is usually used and often
additional funds are added to reserves. She expressed her concern about the
potential loss of select State-funded grants compared to federally funded
grants, which seem to be more stable or even receive increased funding when the
economy is poor. Dr. LeBailly noted that State Per Capita for public health
services was not cut out of the State’s budget this year, although it did
receive a slight reduction from the original funding formula amount.

Ms.
Macpherson stated that the department expects to see some increased revenues of
about $100,000 with the food license fee increases for 2010. ISDS fees will
also increase, but overall revenues in that program will not until the economy
recovers. She reported on the WIC Program’s increase in grant funds, which
will allow the Department to increase staff and remodel areas of the Loveland
office to accommodate this expansion, as well as have a computer self check-in
window, as the program funds do not support a receptionist. A remodel of the
reception/vital records window area in the Fort Collins office is required due
to the new vital record security standards and safety.

With
regard to Personnel line items, Ms. Macpherson described the increases in the
County’s Retirement Plan and the Commissioners’ decision to not give pay
increases to employees in 2010 due to the budget constraints county-wide caused
by current economic conditions. In general, the overall personnel costs
increased by approx. $25,000 in 2009, mainly due to some increases in the WIC
Nutrition Program. It is anticipated that the personnel costs will go down in
2010 with the loss of certain grant funds.

Board
Member Steve Yurash acknowledged that the budget information distributed
contained a lot of detail and requested a more global picture specifically
related to labor costs that might differentiate between grant labor costs and
non-grant labor costs. While this information is part of the budget
development effort, it was not complete by this meeting time. Ms. Macpherson
agreed to email this analysis to the board at a later date, including a roll-up
of the FTEs/labor costs associated with grant versus non-grant activities. She
did note that the detail of the Department’s accounting system helps the
Department make good fiscal decisions.

***Motion
was made that revised 2009 and 2010 budget proposals appear reasonable and to
move forward as planned.

***Motion was unanimously passed.

4.
Update on Pandemic Flu –
Dr. LeBailly

Dr.
LeBailly updated the members of the Board on the 2009 H1N1 Pandemic flu, and
her concerns that the outbreak will escalate quickly now that schools have
re-opened. The CDC has issued pandemic flu guidance for K-12 schools and
businesses in past week, and for Higher Education today. The Health Department
has communicated on workplace issues with the HR department. We had hoped the
county might be more flexible with those employees who had little or no sick
leave, so that they would not have an incentive to come to work sick. So far
that does not seem to be happening. The CDC’s guidelines allow most workers to
return to the workplace 24 hours after a fever has resolved (off fever-reducing
medicines). However, it’s likely that employees will be shedding virus before
they become ill and even after they return to work, and some will be
asymptomatic, so you should assume anyone could be shedding flu virus. It’s
important to continue to wash hands, cover coughs, keep hands away from nose
and mouth, etc.

Dr. LeBailly
discussed the unpredictable public demand for the vaccine, and the enormous
logistical challenges of organizing a mass vaccination campaign involving tens
of thousands of immunizations. She also discussed the reimbursement allowed for
administration by vaccinators. [At the time of the meeting, it appeared
local health agencies could charge, but since then that decision has be
reversed.] The logistics of organizing the response effort, getting local
providers enrolled to receive H1N1 vaccine, and getting antivirals out to high-risk
persons within 48 hours have also been enormous. She also discussed some
school closure issues.

5.
Director’s Report – Dr.
LeBailly

·
Dr. LeBailly provided the BOH an
update on West Nile Virus and the level of infected mosquitoes in the county.
No spraying as occurred in the Fort Collins area this summer. While WNV case
numbers have been fairly low, we’ve seen some severe disease in relatively
young people.

·
Dr. LeBailly discussed the State
Public Health Improvement Plan Critical Input meeting held in Fort Collins on
August 4, 2009. She also briefly mentioned the 2009 NACCHO Conference she
attended July 29-31.

·
The Department’s Budget hearing is
to be held September 15, 2009 at 10:30am, at the courthouse. Dr. Richards will
attend.